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NPI Code Detail

MEDICARE: DR. JUDY ANN HART PSYD

MEDICARE:  DR. JUDY ANN HART  PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist2984OR

Other Identifiers

General Provider Information

NPI Number : 1720094956
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUDY ANN HART PSYD
Provider Business Mailing Address
First Line : 211 SE CARUTHERS ST
Second Line :
City : PORTLAND
State : OR
Zip : 97214-4502
Country : US
Telephone Number : 503-224-1044
Fax Number : 971-260-0355
Provider Business Practice Location Address
First Line : 211 SE CARUTHERS ST
Second Line :
City : PORTLAND
State : OR
Zip : 97214-4502
Country : US
Telephone Number : 503-224-1044
Fax Number : 971-260-0355
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 02/25/2025

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Directions to “ DR. JUDY ANN HART PSYD” Practice Location

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